Scheuermann Disease

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Etiology/Pathophysiology:
Due to irregularity of ossification of one or more vertebral endplates. Fissures develop in the vertebral cartilage and endplates and they open up and there is herniation of disc material, fibrosis follows and Schmorl's nodes (sclerosis) forms in reaction.

Pathology:
Not applicable

Imaging Findings:
Diagnosis is based on radiological evidence of kyphosis exceeding 35 degrees with at least one vertebral body wedged 5 or more degrees. Most frequently seen between T7-T10 but it can be seen anywhere from T4 to L4. One third of the patients have a mild scoliosis. On plain film see intervertebral disc narrowing that is greatest anteriorly, Schmorl's nodes in anterior or central portions of the discs, anterior wedging of the vertebral bodies with irregular margins and indistinct cortical outlines, and irregular ossification of the ring apophyses.

DDX:

• Trauma - usually produces wedging at one level instead of several like Scheurmann's
• Tumor or infection - rarely involve multiple vertebra in a uniform fashion

References:
See References Chapter.

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